611: The effects of pre-pregnancy BMI and antenatal weight change on adiopocytokine levels

Abstract

Numerous adipocytokines are implicated as contributing factors to various perinatal disease states, though data are conflicting. This study aims to determine the influence of pre-pregnancy body mass index (BMI) and antenatal weight changes on the maternal and fetal levels of adiponectin, leptin and resistin, in healthy women. This was a prospective cohort study of healthy non-smoking women without gestational-diabetes, with singleton gestations. Maternal serum was collected between 32-34 weeks, with maternal and cord blood collected at delivery. Plasma adiponectin, leptin and resistin were measured using commercial immunoassays. Cohorts were defined in two modes: BMI <25 vs. ≥25 and gaining ≤ Institute of Medicine (IOM) weight recommendation vs. > IOM recommendations. Analysis performed using T-test with bootstrapping, Chi-square tests and Spearman’s correlations, with generalized linear models to control for confounding. 61% of subjects began pregnancy with a BMI ≥25, of whom 65% exceeded IOM weight gain recommendations. 62% with a BMI<25 exceeded IOM recommendations (P=0.77). There were no significant demographic differences between groups. Leptin levels were significantly higher in maternal and fetal subjects who exceeded IOM recommendations, which persisted after controlling for BMI. Women with a BMI<25 had higher 32-34 week and term adiponectin levels and lower leptin levels, which persisted after controlling for weight change (Table 1). Leptin demonstrated a significant positive correlation with net weight change at 32-24 weeks and term (Table 2). A negative trend between net weight change and term adiponectin levels was noted, with a significant negative correlation between pre-pregnancy BMI and both 32-34 week and term adiponectin levels. A woman’s BMI at conception influences third trimester adiponectin and leptin levels, with a lesser impact on resistin. Exceeding IOM weight gain recommendations (regardless of BMI at conception) effects only leptin levels.View Large Image Figure ViewerDownload Hi-res image Download (PPT)